背景:免疫接种是保护5岁以下儿童免受一系列疾病侵害的重要预防措施。在中国,通过利用公共卫生工作者的建议,可以提高非国家免疫计划(non-NIP)疫苗的覆盖率.因此,了解推荐行为的影响因素至关重要。本研究旨在调查公共卫生工作者对非NIP疫苗推荐行为的影响因素。特别强调经济激励。
方法:在2019年8月至10月使用多阶段抽样方法进行了横断面调查。从中国十个省级行政区划的148个社区医疗中心招募了627名公共卫生工作者。匿名问卷被用来收集人口统计信息,对疫苗接种的态度,以及对非NIP疫苗的推荐行为,包括b型流感嗜血杆菌(Hib)疫苗,肺炎球菌结合疫苗,水痘疫苗,和轮状病毒疫苗。本研究采用描述性分析和多因素logistic回归分析。
结果:在610名拥有完整调查数据的公共卫生工作者中,53.8%,57.4%,84.1%,54.1%经常推荐Hib疫苗,肺炎球菌肺炎疫苗(PCV),水痘疫苗,和轮状病毒疫苗,分别。Logistic回归显示性别(Hib疫苗:OR=0.4,95%CI:0.2-0.8;PCV:OR=0.4,95%CI:0.2-0.8;轮状病毒疫苗:OR=0.3,95%CI:0.2-0.6),非NIP疫苗接种的财务激励措施(Hib疫苗:OR=1.9,95%CI:1.1-3.6;PCV:OR=2.1,95%CI:1.1-3.9;轮状病毒疫苗:OR=2.0,95%CI:1.1-3.8)和对疫苗安全性的看法(Hib疫苗:OR=2.7,95%CI:1.1-7.0;PCV:OR=3.2,95%CI:1.2-8.0;轮状病毒与健康相关PCV和轮状病毒疫苗。
结论:研究结果强调了中国公共卫生工作者对非NIP疫苗的推荐行为,并揭示了疫苗推荐与经济激励之间的强关联。这凸显了中国公共卫生工作者对非NIP疫苗的建议中经济激励的重要性。建议为公共卫生工作者提供适当的激励措施,以鼓励在免疫实践中有效促进健康。
BACKGROUND: Immunization is a crucial preventive measure to safeguard children under five years old against a range of diseases. In China, the coverage rate of non-National Immunization Program (non-NIP) vaccines can be improved by leveraging the recommendation from public health workers. Hence, understanding the influencing factors of recommendation behaviors assume paramount importance. This study aims to investigate influencing factors of public health workers\' recommendation behaviors towards non-NIP vaccines, with a particular emphasis on financial incentives.
METHODS: A cross-sectional survey was conducted using a multi-stage sampling method in 2019 from August to October. 627 public health workers were recruited from 148 community healthcare centers in ten provincial-level administrative divisions in China. An anonymous questionnaire was used to collect demographic information, attitudes towards vaccination, and recommendation behaviors towards non-NIP vaccines, including Haemophilus influenzae type b (Hib) vaccine, pneumococcal conjugate vaccine, varicella vaccine, and rotavirus vaccine. Descriptive analysis and multivariate logistic regression analysis were adopted in this study.
RESULTS: Of the 610 public health workers with complete survey data, 53.8%, 57.4%, 84.1%, and 54.1% often recommended Hib vaccine, pneumococcal pneumonia vaccine (PCV), varicella vaccine, and rotavirus vaccine, respectively. Logistic regression revealed that gender (Hib vaccine: OR = 0.4, 95% CI: 0.2-0.8; PCV: OR = 0.4, 95% CI: 0.2-0.8; rotavirus vaccine: OR = 0.3, 95% CI: 0.2-0.6), financial incentives for non-NIP vaccination (Hib vaccine: OR = 1.9, 95% CI: 1.1-3.6; PCV: OR = 2.1, 95% CI: 1.1-3.9; rotavirus vaccine: OR = 2.0, 95% CI: 1.1-3.8) and perception of vaccine safety (Hib vaccine: OR = 2.7, 95% CI: 1.1-7.0; PCV: OR = 3.2, 95% CI: 1.2-8.0; rotavirus vaccine: OR = 3.0, 95% CI: 1.2-7.7) were associated with public health workers\' recommendation towards Hib vaccine, PCV and rotavirus vaccine.
CONCLUSIONS: The findings highlighted public health workers\' recommendation behaviors of non-NIP vaccines in China and revealed strong association between vaccine recommendation and financial incentives. This highlights the importance of financial incentives in public health workers\' recommendation toward non-NIP vaccines in China. Proper incentives are recommended for public health workers to encourage effective health promotion in immunization practices.